NPC Meeting Minutes: 5/24/11 – 5/26/11, Milwaukee WI

Susan Anderson (NAGE) Bonnie Miranda (VBA) Donna Taylor (VHA) MJ Burke (AFGE) Edson Morales (LMR) William Schoenhard (VHA) Robert Callahan (VHA) Juan Morales (VHA) Stephen Warren (OIT) Alberta Franklin (VHA) Claudia Moore (NAGE) Bill Wetmore (AFGE) Ryan Fulcher (LMR) Christine Polnak (SEIU) Irma Westmoreland (NNU) Elaine Gerace (SEIU) Glenn Powers (NCA) Crystal Wiggins (OIT) Anitra Jones (LMR) Robert Redding (NFFE) Leslie Wiggins (LMR) Patricia Lasala (NFFE) Cathy Rick (VHA) Alma Lee (AFGE) Donna Terrell (VBA)

Welcome – Guests were welcomed and introductions around the table followed. There were several observers in attendance: Anita Hanson from NCA. Edson Morales was introduced as new LR Specialist with the VA Office of Labor Management Relations.

Executive Order-SRA Kristy Townsend Review of the Executive Order 13522 Instructor-led training Pilot session in St. Louis, MO the week of June 2. She identified four labor-management forum levels and the type of training needs for levels 1 and 2 facilities. Need to identify 30 trainers (teams of two) - 15 management and 15 union. NPC decided that the facilities which need the training should be identified first then select the trainers. SRA will then provide the train the trainer sessions. The NPC also decided that a joint communication letter from the NPC would go out from each Administration which will provide a cover letter and would go down to each facility at the intermediate and lower level. The NPC EO subcommittee will draft the letter and will go out by mid-July. The letter should include notification of new opportunity for improvement, business case for training and signed by all NPC members. NPC will provide a list of trainers to SRA by mid-June.

VHA Update-William Schoenhard Ms. Cathy Ricks received an honorary doctorate degree from Marquette. Family caregivers provide crucial support in caring for our Nation’s Veterans by allowing them to stay in their homes and communities and surrounded by their loved ones. There are approximately 3,000 potential veterans eligible for a new program called Caregivers for catastrophically injured service members. Veterans eligible for this program are those who sustained a serious injury or mental disorder incurred or aggravated in the line of duty. VHA continues to gather data for vouchers for the homelessness program. Vouchers for living quarters are a means for reducing Veteran homelessness. The Affordable Health Care Act puts new pressure on the VA to remain competitive, especially with the declining number of veterans at some VA facilities. Without a competitive advantage many veterans will opt for the private sector which is not experienced to handle our Veteran clientele. In response to Mr. Shoenhard, MJ Burke advised that facility funding does not appear to go where it should. Two facility directors responded that funding allocations are well tracked, which includes PACT as an example. Leslie mentioned that it would be a good idea for VHA to begin incorporating the metrics NPC developed at the forum levels.

NCOD-Sue Dyrenforth and Maureen Cash Ms. Sue Dyrenforth discussed the All Employee Survey results. Overall, the Department’s employee participation scored lower than last year at 68%. VHA was at 68%, VBA at 60%, NCA at 60%, and VACO at 40%. Ms. Dyrenforth mentioned that the results may be due to survey fatigue. She also mentioned that CREW workgroups are recognized and VA is collaborating with Fortune 500 companies so they can institute CREW. Maureen Cash reviewed the data that NCOD has gathered after conducting the forum survey. Stephen Warren expressed dissatisfaction with the fact that OI&T was not identified on the NPC Meeting Minutes: 5/24/11 – 5/26/11, Milwaukee WI survey. Leslie agreed to meet with Crystal Wiggins and OI&T on a subgroup to close this gap and will report back to NPC at the next meeting. Those members are Alma Lee, Christine Polnak, Crystal Wiggins, and Leslie Wiggins.

Clinical Documentation Systems -ONS Cathy Ricks, Alicia Levin Clinical Information Systems (CIS)/Analytics Clinical Flow sheets Patient Assessment Documentation Package (PADP) will replace paper records. The CIS will record data from multiple sources, integrate clinical information; provide real-time warnings with multiple user-defined views. This is a VISN centric program that will requests union participation in the product evaluation. This will be a phased rollout with 12-18 sites in 3 week timetables. The end user training will be 4 hours and web-based. Training will take place during the shift. Presentations to NAGE and NNU have taken place already. The Institute of Medicine report will be resent to NPC by Cathy Rick.

Office of Nursing Service Update-Cathy Ricks Nursing Handbook presentation. Changes to the Handbook set the stage for federal authority and mandates that Advanced Practitioner’s work to the top ability of their licensing in a standardized way. Advanced Practitioner’s will be independent practitioners and will go from a scope of practice to credentialing. State boards will be notified that federal supremacy reigns over State licensing. ONS has been working with OGC to ensure full legal authority exist for this independent practice. OGC has written a legal opinion regarding the matter. The National Practitioner Database has been informed and the Handbook still has to go through the concurrence process and then to the Unions. LMR will contact OGC and request a copy of the legal opinion to distribute to NPC.

Wellness is Now Program (WIN)-Kara Szirotnyak Ms. Kara Szirotnyak updated the NPC on the progress of the WIN program rollout. VBA and NCA have had limited contact with the WIN program. OIT was not in the original request when it was sent out, but this is being amended and should be ready by September. Leslie reminded everyone that WIN is the PDI metric that was chosen by the NPC. MJ stated that tension was present on the Steering Committee between the Unions and VHA in wanting to hang on to and control their program.

NPC will develop an electronic letter from NPC with the health assessment link and promotional flyer embedded in the letter. The goal will be to complete the NPC endorsed letter within 1 week. Claudia Moore asked about additional meetings that have taken place with the Steering Committee. Kara stated she invited the Unions to the face-to-face but nobody showed up from labor. Kara will schedule a call for the Unions that were on the call to review and clarify concerns. The NPC agreed that an increase in HRA completion rate of 30% by September 2011 is the goal.

MJ asked for a monthly report of the data for the # of HRA health assessment completion. Kara will send to Anitra for NPC distribution. Anitra will be on the WIN Steering Committee email group.

OIT Update-Stephen Warren OIT is doing a service survey and their scores have improved since last year. Focus on securing Veteran information and VA data protection. The IT budget in 2012 will be less than 2011. Citrix for employee’s personal computers can provide remote access and has been a big issue. This service should be live by 7/1. Service line pilot is finished and MOU’s are in place. Eric Raffin will provide an update at the next NPC meeting. NPC Meeting Minutes: 5/24/11 – 5/26/11, Milwaukee WI

DFAS Payroll-Roy Coles Mr. Coles addressed some of NPC’s concerns. When asked why remedy tickets couldn’t be resolved at the local level, he informed NPC that this issue was something that he wanted to get resolved. Regarding overpayments and underpayments, MJ brought up that letters go to employees with timeframes for filing a waiver when an overpayment occurs. Employees are not being sent a waiver letter in time which is a statutory requirement. Roy Coles will send a copy of the waiver letter to LMR. When emergency payments are required, MJ wanted a POC between Payroll and the Unions. On the issue of RN comp time and ETA, Mr. Coles stated that he will contact ETA to inform them that the edits need to be removed to allow the display any unused RN Comp Time balance beyond 7 pay periods for up to the 26 full pay periods. Mr. Coles will notify LMR who will then notify NPC of when this will happen. Under the new web-based ETA system, automatic email notices will go to employees to notify them that their comp time is close to expiring. Roy Coles will send LMR the contact information for his new Deputy Director Raven Thompson. With the addition of Ms. Thompson to his staff, Mr. Coles noted that he expects response time to the unions to be no greater than 48 hours.

NCA Update-Glenn Powers Steve Muro had senate confirmation hearing but is awaiting final confirmation. FY 2010, NCA conducted 112,000 internments. VALU offered training is being utilized by NCA. Mr. Powers reviewed the organizational hierarchy of NCA and they have increased their forum level to be consistent with the other administrations. NCA is also getting involved with AFGE and NAGE for a national level meeting. Leslie noted that at the next meeting, NPC can review how much progress is being made with the timeliness, grounds and safety metrics that NCA developed. Per the last NPC conference call, it was decided that the intermediate level for NCA would be the Field Programs Level rather than the MISN level. Alma recommended that MISN’s have a representative present at these meetings and AFGE could have a representative from each MISN.

Telework-Deborah Munn Reviewed the current VA Telework plan and reviewed the new Telework Enhancement Act of 2010. Ms. Elaine Gerace asked if it was appropriate for a supervisor to send out a group notice to employees that did not specify a reason for ineligibility for telework. Ms. Munn advised that this is not the intention of the notice instead they are to be addressed to individual employees and specify the reason for ineligibility. Susan Anderson stated that the work committee didn’t have much input into the final draft of the policy, which has not yet been seen. Ms. Munn stated that a review has taken place but that the policy is not finalized. Ms. Anderson pointed out that there were several employee eligibility criteria that the unions all did not agree to. Ms. Anderson stressed that the letters were not negotiated and did not like the “Other (specify)” option of ineligibility. Ms. Munn stated that not every possible ineligibility reason could be covered in the letter. In addition, the intent is to hold the supervisor accountable for their rationale in denying telework, which can be grieved. Leslie stated that the VA has gone above what the law requires by holding supervisors accountable. In addition, Leslie stated that the VA has to do things in compliance with the law. Leslie asked if Ms. Anderson ever responded to the highlighted draft language in the policy that was sent out? Ms. Munn can go to the telework coordinators in the field and ensure that the forms are being distributed correctly. Alma Lee stated that AFGE submitted a demand to bargain and that the form was not negotiated. She said that there should have been a draft form sent to employees that said it was subject to change. Ms. Patricia LaSala from NFFE San Francisco VAMC notified Ms. Munn that she instructed employees at the medical center not to sign the form. Ms. Munn will send the link to telework training, the policy draft and page 2 of the letter. NPC Meeting Minutes: 5/24/11 – 5/26/11, Milwaukee WI

NNU Update-Irma Westmoreland Sadly, the Durham NNU Director passed away. Contract negotiations start in June. NNU wants to get this done as quickly as possible. On June 5, NNU is bringing 1500 RN’s to DC for congressional meetings and lobby day. They will be speaking with Senators about patient – nursing employee ratios, safe lift handling, staffing methodology, and workplace violence. NNU respects the VA Healthcare System and often touts it as an exemplary system.

AFGE Update-Alma Lee Contract training is beginning soon, one in each VISN, one in each area for VBA and one for all of NCA. Regarding MSA downgrades, Ms. Lee met with VACO last week and it has been agreed to write a whole new PD for MSA’s.

Caregiver Support Program-Deborah Amdur Discussed Caregiver statistics and stress levels of veterans ‘caregivers. Expanding the use of respite care is a major goal. She reviewed Public Law 111-163. The law ensures a level of consistency by requiring certain types of care, such as respite care and telehealth, at all medical centers. The Caregiver Support Coordinator is a new position required by law and adds an additional FTE for each medical center. A standardized curriculum will be used to develop and mold these employees. Why this program is not available for all era veterans has been a major point of contention. Mr. Callaghan asked about the flexibility of Caregivers to do other duties if there are not many eligible veterans at a facility. Ms. Amdur expressed that right now these caregivers need to stay dedicated to their caregiver duties. Ms. Anderson asked about funding: Congress has authorized 5 years of funding at which point the funding will either be renewed or discontinued.

NPC Metrics-Leslie Wiggins Ms. Wiggins pointed out that metrics are a vital component of EO 13522 and an opportunity to demonstrate that metrics do lead to greater accountability, efficiency and productivity in all levels of the organization. Leslie also emphasized the importance of Richard Sasoon’s presentation on metrics to the council. Leslie also heavily emphasized the importance of placing these metrics on forum agendas. Leslie wants to make sure everyone is on the same page before going to the national council in September. The goal of the metrics needs to be realistic and attainable. Ms. Bonnie Miranda asked how this message could get to front line employees. Leslie responded that this type of information needs to be communicated by both management and labor by promoting the metrics through their proper channels. Local Forums should take on projects in support of the metrics. It is through project completion that metric results are measured. Bill Wetmore suggests that all level forums should be pushing the WIN program and the other NPC metrics. Vivieca Wright suggested that a Recommendation from the Under Secretary for Health be issued requesting labor involvement in the Quality Council. All unions expressed an interest.

NPC voted to target a 25% increase in the number of Level 3 facilities by September, 2011. Bob Redding recommends looking at the increase from Level 1 to Level 2. VBA’s metric goals are for the end of FY 2012, not by the beginning.

ONS Update-Alan Bernstein/Ila Flannigan RN residency program is in a transitional phase right now to address the turnover rate of RN’s in their first year of employment. ONS wants to standardize the education that nurses receive. Ms. Elaine Gerace pointed out that it’s usually the first 2 years where attrition rates are highest. She asked if this NPC Meeting Minutes: 5/24/11 – 5/26/11, Milwaukee WI was only for the baccalaureate and it is not. Susan Anderson addressed the fact that the program may encounter resistance because it is divided into three phrases and may increase the burden upon current RN’s. Alan responded that only during the first phase of the process are they not counted as being on the unit. Ms. Irma Westmoreland stated that if we don’t take the impact now, we will take it later through attrition.

NAGE Update-Susan Anderson There has been restructuring occurring in NAGE national offices. A major concern for NAGE across the country is the lack of PDI and forums. An organization associated with the state of Massachusetts is partnering with VA to hire veterans with special needs.

NFFE Update-Bob Redding NFFE is waiting on final approval of the new contract. NFFE is working actively at some of their level 1 stations and Leslie has been actively assisting. The B1 project is moving along with Alma’s concurrence and lobby week is in May.

SEIU Update-Christine Polnak SEIU has been active in Wisconsin.

Guests: Andrew Pacyna- Associate Director of Milwaukee VAMC, VBA Regional Office Director, AFGE Local President Roberta Sharbutt. AFGE has withdrawn from VBA forum but the VHA forum charter is being finalized. Bonnie Miranda offered to sit down and help figure out what is happening with the VBA forum meetings.

VBA Update-Bonnie Miranda/Donna Terrell VBA is assisting employees that have fallen victim to the Midwestern/Southern tornadoes by providing temporary housing. VBA and the Department as a whole have been cited as violating many of the acquisition regulations. Only contracting officers are authorized to make purchases over $3,000. Leslie stated that VHA has many people that do this 100% of the time and are not Contracting Officer’s. What to do with these employees is a serious concern.VBA is also gearing up for post 9/11 GI bill and paying the monthly housing allowance. National guardsmen are now eligible for the GI bill which will increase VBA’s workload.

VBMS-Mark Bologna VBMS has put about 180 cases in a live processing environment in Providence, RI. 20 – 22 cases have been completed with this system. Mark has received user feedback that has been very helpful. Mark stated that on average VBA is seeing a 70 day case completion rate but it is much too early to tell. Testing at Salt Lake City Regional Office was kicked off two weeks ago and they will receive a live version in 2 weeks. VBMSR software will begin in mid-June. Alberta requested that someone from AFGE see the system in Providence, and details will be worked out for either a remote viewing or in-person. Mark will be able to provide another update to NPC in August. NPC Meeting Minutes: 5/24/11 – 5/26/11, Milwaukee WI

Action Item Tracker Reviewed and updated items. Please see current tracker.

NPC Item Tracker.xls

Looking Ahead:  August 1-5 in Seattle. Bonnie will check if the RO has space available.  September meeting was cancelled. Two calls in September need to occur.  October 31 – November 4 will be in West Palm Beach, FL